POS0713 A HISTORY OF POLYMYALGIA RHEUMATICA IS ASSOCIATED WITH ADVANCED SUPRA-AORTIC VASCULAR DAMAGE AT DIAGNOSIS OF GIANT CELL ARTERITIS
Authors: A. Hemmig, M. Aschwanden, C. Berger, D. Kyburz, N. Mensch, D. Staub, M. Stegert, S. Imfeld, T. Daikeler
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Subclinical giant cell arteritis (GCA) can be found in imaging studies at diagnosis of polymyalgia rheumatica (PMR) in up to 30% of patients [1]. Newly diagnosed GCA patients with a preceding PMR diagnosis may therefore present with more advanced vasculitic vessel alterations than GCA patients without prior PMR. <h3>Objectives</h3> To compare vascular ultrasound (US) findings in newly diagnosed GCA patients with and without a history of PMR. <h3>Methods</h3> Retrospective analysis of patients with GCA diagnosed at the University Hospital Basel between 12/2006 and 05/2021. <h3>Results</h3> 49 of 311 newly diagnosed GCA patients (15.8%) had a preceding diagnosis of PMR a median of 2.5 (IQR 0.6-5.6) years earlier. US revealed vessel wall alterations typical for vasculitis in the supraaortic vessels (carotid, vertebral, subclavian and/or axillary arteries) more often in patients with prior PMR than without PMR (51% vs 25%, p&lt;0.001). Additionally, patients with prior PMR had more often significant vascular stenoses in the supraaortic vessels that were affected by vasculitis (37.5% vs 13.6%, p=0.03). Patients with and without prior PMR did not differ in terms of ischemic complications of stroke or vision loss at GCA diagnosis nor in the number of vascular segments with atherosclerosis (Table 1). In multivariable analysis, prior PMR was significantly associated with vasculitic vessel wall alterations (OR 4.28, 95% CI 1.92–9.85, p&lt;0.001) adjusted for sex, headache, scalp and temporal artery tenderness. Furthermore, prior PMR was associated with vascular stenoses (4.97, 95% CI 1.4–19.12, p=0.015) adjusted for age, sex, arteriosclerosis, cerebrovascular and coronary heart disease. <h3>Conclusion</h3> GCA patients with prior PMR had a more extensive vascular involvement on ultrasound than those without prior PMR at diagnosis. Presence of stenoses could not be explained by arteriosclerosis. Undiagnosed subclinical GCA in patients with previous PMR may be a cause of more advanced vascular changes. These data support the need for screening strategies for GCA in patients with PMR. <h3>Reference</h3> [1]Hemmig AK, Gozzoli D, Werlen L, et al. Subclinical giant cell arteritis in new onset polymyalgia rheumatica A systematic review and meta-analysis of individual patient data. Semin Arthritis Rheum. 2022. 28;55:152017. <h3>Acknowledgements</h3> The authors would like to thank the Swiss Foundation for Research on Muscle Diseases (FSRMM) for supporting the Ph.D. of Andrea Hemmig. <h3>Disclosure of Interests</h3> Andrea Hemmig: None declared, Markus Aschwanden: None declared, Christoph Berger: None declared, Diego Kyburz Consultant of: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, Roche, Grant/research support from: Abbvie, Noemi Mensch: None declared, Daniel Staub: None declared, Mihaela Stegert: None declared, Stephan Imfeld: None declared, Thomas Daikeler: None declared.